Child advocate has lawmakers rethinking abuse, neglect placements


New Hampshire Bulletin

Published: 09-09-2023 10:09 PM

It looks certain that New Hampshire lawmakers will introduce legislation this week that would tighten the state’s ability to place neglected and abused children in institutional settings when their own homes are unsafe.

The inspiration? A pair of reports from the state’s child advocate detailing her concerns about Bledsoe Youth Academy, a Gallatin, Tennessee, facility for boys 12 to 18 used by the Department of Health and Human Services.

In her most recent report, released Wednesday, Child Advocate Cassandra Sanchez said the two New Hampshire children whom she asked the department to return from Bledsoe have shared additional concerns about their treatment since coming home. They include threats of retaliation for talking with New Hampshire authorities.

Sanchez also quoted a former Bledsoe employee who contacted her office after she first raised concerns about the facility in August. Those concerns included physical and emotional mistreatment of children and a culture of punishment. The employee had a message for states still placing their children at Bledsoe, according to Sanchez: “Go get your kids today!”

While the two children at Bledsoe have been returned to New Hampshire, as of late August there were nearly 90 youths being served out of state, including 10 outside New England, in Arkansas, Florida, Mississippi, Missouri, Pennsylvania, and Tennessee, said Health and Human Services spokesperson Jake Leon. Children in abuse and neglect cases are placed in facilities when there are no suitable family or foster homes available.

Rep. Mark Pearson, a Hampstead Republican and chairman of the House Children and Family Law Committee, said Wednesday that he has begun drafting legislation with the committee’s vice chairman, Democrat Patrick Long of Manchester, ahead of Friday’s filing deadline.

“The main issue initially is to make sure that any facility where a New Hampshire child is placed, whether that is in-state or out-of-state, is a good one and that it has been evaluated on site and that we’ve investigated it,” Pearson said. “We are on a deadline, and on one hand, we don’t want to rush this and have bad legislation. On the other hand, this is a pressing issue.”

Sen. Sharon Carson, a Londonderry Republican who has co-sponsored other legislation aimed at protecting children, is reviewing Sanchez’s reports and will also file legislation if appropriate, said Maya Harvey, Senate spokesperson.

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The department’s inspection and evaluation of Bledsoe are in dispute. 

In her first report, Sanchez said that while the Division for Children, Youth, and Families had been checking in with the two children at Bledsoe, the department had not visited Bledsoe in person for a facilities evaluation before awarding it certification in 2021 or recertifying it in 2023. 

Leon told the Bulletin in August that the department had fulfilled its obligations when it certified Bledsoe for out-of-state placement and is investigating whether more visits to facilities would be appropriate.

Sanchez noted in her first report that a simple internet search of Bledsoe or its operator, Youth Opportunity Investment, would have been enough to warrant reconsideration. The search results include a 2017 report of arrests at the center following a disturbance and low reviews from prior employees saying they were unwilling to provide details for fear of retaliation. 

Sanchez made 11 recommendations in her August report that included requiring the department to visit out-of-state facilities in person on a quarterly basis.

It’s also likely lawmakers will continue pushing to increase “upstream” support services aimed at keeping children and families safe, without intervention from the state. 

In an August interview, Sen. Becky Whitley, a Hopkinton Democrat, said she remains focused on legislation that would expand those kinds of treatments and protections.

Recently, that effort included more money for Medicaid services, such as counseling and child care, and the prioritization of preventive care that allows children and families to remain safely home. 

Looking ahead, Whitley said she would like to see more schools offer Multi-Tiered Systems of Support, where struggling students get increasing levels of services, depending on their needs. Whitley said the school districts currently offering the program are relying on federal dollars.

Whitley hoped to expand that with state money this year through Senate Bill 265. While the state budget included $900,000 to expand the program, Whitley’s legislation calling for more money failed. She said she remains committed to growing that program.

Whitley said she is also looking into reports that families with private insurance are not getting coverage for the same level of mental health care that Medicaid must cover. She and former state senator Tom Sherman attempted to remedy that a few years ago without success, she said. 

Whitley said she may submit legislation addressing that when the Senate filing period begins Sept. 28.

“I don’t know if it’s a study committee. I don’t know if it’s an insurance mandate,” she said. “But it is an area that I think we really need to look at.”

In a statement, Kathy Remillard, Health and Human Services spokesperson, pointed to what she described as the success of prior efforts to better protect kids.

“The implementation of juvenile justice and Children’s System of Care strategies have led to more youth receiving services in their home communities and fewer youth placed in residential settings,” she said in an email. “Over the past several years, New Hampshire has seen a 50% reduction of juvenile justice-involved youth in placement.”

Worst fears confirmed

Former child advocate Moira O’Neill began visiting children in facilities when the office was created in 2018. When Sanchez replaced O’Neill in 2022 she visited seven facilities that year, including one in Arkansas. The following year, she visited more than a dozen in New Hampshire and New England. 

At each stop, Sanchez talked with the children and staff separately and then followed up with recommendations.

This year, she chose to travel to Tennessee because the state was using two facilities there, Bledsoe and Hermitage Hall in Nashville. 

The visit to Bledsoe was so alarming that Sanchez reported her safety concerns to the Tennessee Department of Children’s Services from the parking lot, something she had never done.

In her latest report, Sanchez said she contacted the department again after her return to relay the boys’ new disclosures.

She was told the department had closed its investigation because Tennessee state law requires reports to identify a specific staff member as the alleged perpetrator and a specific child as the victim. Sanchez also reported her concerns to the state licensing officials.

The Tennessee Department of Children’s Services declined to discuss the case when contacted by the Bulletin Wednesday. 

“We can confirm additional investigations have commenced in this case, and we are working with the Department of Mental Health who licenses the facility,” read an unsigned email from the agency. “However, pursuant to state and federal law, we are unable to release case-specific information regarding children or families served by the Department of Children’s Services.”

During their first conversations with Sanchez, the boys told her and her team that staff offered them incentives to assault other children. Cameras in bedrooms left little privacy to change. Kids suffered rug burns while restrained face-down on a carpet. 

Sanchez said she learned even more from the children once they were back in New Hampshire, separate placements she described as warm, supportive, and welcoming. She detailed their new disclosures in the report released Wednesday.

Independently, the boys reported that an adult female staff member in her 20s and one of the boys had an inappropriate relationship. Staff had kids watch inappropriate movies that one of the children described as pornographic, Sanchez wrote. 

Following Sanchez’s visit to Bledsoe, the two New Hampshire boys said they overheard staff say they had “snitched.” Staff separated the boys, according to Sanchez’s report, and threatened to beat them both up if they did not reveal which one had shared concerns with Sanchez and her team. 

Sanchez wrote that the older boy offered to take the blame because the other boy was “smaller and cannot fight.”

One boy said that two days before he returned to New Hampshire, someone shut the bathroom lights off and entered the stall where he was, which was out of the camera’s view. 

“I couldn’t see anything. He was swinging so I started swinging,” Sanchez quoted the boy as saying. “I hit the wall, the toilet, I don’t know, I couldn’t see.”

Both boys said they did not have a therapeutic experience at Bledsoe. One boy said his time there had made him feel “institutionalized.” The other said he had become skittish.

The former Bledsoe employee who contacted Sanchez had worked at the facility briefly as a therapist before resigning. “Throughout the conversation, the former employee recalled multiple incidents where staff berated the children,” Sanchez wrote, “were both verbally and physically aggressive towards the children and consistently provided harsh punishment for even minor missteps.”

When Sanchez asked the employee why they had contacted her office, the person said, “I am really concerned for all those children,” Sanchez wrote.

Sanchez concluded her reporting by saying it’s not enough to only remove the New Hampshire children from Bledsoe. No child should be there, she said.

Sanchez said her investigation has also underscored the need for the state to better protect the children in its care. “It is also imperative that certification and oversight of New Hampshire children must be more closely managed,” she wrote.

Sanchez said the Department of Health and Human Services has cooperated with her investigation and asked her office to collaborate on many of the recommendations included in her first report. 

Remillard, a department spokesperson, said that partnership is critical. 

“As the (Office of the Child Advocate) would acknowledge, the residential treatment system in New Hampshire does not currently meet the individual needs of every youth,” Remillard said in an email. “We continue to focus on system improvements so that all youth who are unable to remain at home have access to the services they need, when they need them, in a safe, appropriate setting that best meets their individual needs.”